In the United Kingdom, Medical Laboratory Professionals Gather to Explore Disruptive Diagnostic Technology, ISO 15189, and How Labs Can Add Value

Two-day conference attracted an international audience of clinical laboratory scientists and addressed major trends in healthcare and laboratory medicine

DATELINE: BIRMINGHAM, ENGLAND—This week in the industrial heartland of the United Kingdom, pathologists and medical laboratory professionals gathered for the 13th Annual Frontiers in Laboratory Medicine (FiLM) conference. The hot topics were new quality management standards for labs in the UK, innovative ways to improve utilization of clinical laboratory tests, and how first mover laboratories in the United Kingdom are using such disruptive technologies as digital pathology and MALDI-TOF mass spectrometry.

FiLM is co-produced annual by the Association for Clinical Biochemistry and The Dark Report. Over the past decade, it has grown into the largest conference in Europe that addresses the management and operation of medical laboratories and histopathology laboratories.

New Medical Laboratory Standards include ISO 15189

Currently, medical laboratories in the United Kingdom are adapting to changes in accreditation and external quality assurance (EQA—known as proficiency testing in the United States). By 2018, all labs in the UK will need to be accredited to the standards of ISO 15189: Medical Laboratories. As this happens, the United Kingdom will join a growing list of nations that now use ISO 15189 as a basis for licensure and accreditation of histopathology and medical laboratories.

At the 2015 Frontiers in Laboratory Medicine conference that took place in Birmingham, England, this week, leaders in pathology and laboratory medicine participated in a panel discussion about the National Health Service’s Pathology Services Review. From left: Nick Kirk, CSci, President of the Institute for Biomedical Science; Suzy Lishman, M.D., President, Royal College of Pathologists; Ian Barnes, Ph.D., Specialist Advisor the National Health Service; Jo Martin, Ph.D., National Clinical Director of Pathology, NHS England; and, Eric Kilpatrick, Ph.D., President, Association for Clinical Biochemistry. (Photo copyright Dr. Ian Godber.)

On the subject of disruptive technologies, pathologist David Snead, M.D., described the use of a digital pathology system at Coventry and Warwickshire Pathology Services, where he is Cell Path Clinical Lead. This histopathology lab recently acquired the Omnyx digital pathology system and has completed a study to assess any differences in how pathologists would view digital pathology images versus the original glass slides.

According to Snead, the study was based upon 3,050 cases. 10,138 glass slides were imaged at 40X and 1,384 glass slides were imaged at 60X. Overall, there was a strong correlation in how pathologists read the digital images versus the glass slides. However, it was noted that some types of tissue tended to show differently on a digital image versus the glass slide. Plans are to move forward with the deployment of the digital pathology system to learn more about how it can contribute to smoother workflow and improved productivity of histopathologists.

Comparing Medical Lab Management in Australia, Canada, United Kingdom

Utilization of laboratory tests is a big issue for every health system in the world. In a session where medical lab services in Australia, Canada, and the United Kingdom were compared, all three speakers discussed the opportunity for clinical biochemists, pathologists, and medical laboratory scientists to be more proactive in helping physicians order the right test at the right time for each of their patients.

“Healthcare’s transition to personalized medicine and precision medicine opens the door for medical laboratory professionals to help physicians do a better job of diagnosing their patients and selecting optimal therapies,” noted Neil Anderson, Ph.D., Clinical Director, Coventry and Warwickshire Pathology Services in Coventry, England. “This same transition is happening in the United Kingdom, Canada, and Australia, as well as in most developed nations.”

Kilpatrick’s two co-presenters, Ken Barr, Ph.D., Executive Director of SA Pathology in Adelaide, South Australia, and Vince D’Mello, Ph.D., Integrated Laboratory Administrative Director at Grand River and St. Mary’s General Hospital in Ontario, Canada, both agreed with this assessment.

Opportunity for Medical Laboratories to Aid Value with Lab Tests

During both days of the FiLM conference, speakers recognized the need for medical laboratories to become more effective at delivering greater value to the physicians and patients that they serve. “There are two reasons why this is true,” noted D’Mello during his presentation. “First, in most health systems around the globe, the demand for healthcare outstrips the capacity of the health system, particularly because of the increase in chronic disease and the growing proportion of the population who are over 65-years old.

“Second, there is less money in most healthcare systems to pay hospitals, physicians, and medical laboratories,” he continued.

“Not only is it smart medicine to help doctors do a better job of ordering the right lab test at the right moment, but published studies show that improved utilization of medical laboratory tests directly improves patient outcomes and can significantly cut the overall cost of medical care.”

Speaking directly to the ability of medical laboratories to create more value from lab test data, William G. Morice, M.D., Ph.D., Chair of Hematopathology at the Mayo Clinic in Rochester, Minnesota, told the attendees at FiLM that every lab has four ways to develop a consultative laboratory practice that creates improved value from lab test data. They are:

• TECHNICAL: respond to physicians’ questions about assistance in ordering the right lab tests and verifying how diagnostic technology was used to generate the data.

• INTERPRETIVE: respond to physicians’ inquiries for assistance in interpreting data from an individual result.

• INTEGRATIVE: provide assistance to help physicians review and collate a group of individual results.

• SUPPORTIVE: Interact with physicians to help with the knowledge needed to guide the selection of individual tests and appropriately answer clinical questions.

Frontiers in Laboratory Medicine is an International Meeting

Organizers of the Frontiers in Laboratory Medicine conference noted that attendance was at near-record levels and lab professionals from more countries had traveled to Birmingham for the conference this year, thus expanding its international reach. There were also new companies that sponsored at FiLM, which added to the professional networking and knowledge exchange that happens each year at this program.

What is important for readers of Dark Daily is that many of the speakers at FiLM called attention to two fundamental trends that touch every medical laboratory anywhere in the world. First, the standard of quality in lab testing services is being raised. More use of ISO 15189 as the basis for licensure and accreditation is one example. Equally important is the fact that the public wants more transparency in provider outcomes so they can select high-quality providers. Smart lab managers will be responding to this trend by taking steps to improve the quality of their lab’s testing services.

Second, the common reality in most nations is that budgets for medical laboratory testing are being squeezed. To counter this trend, it is essential that pathologists and clinical laboratory managers invest the resources and time needed to create value-added services for the physicians, patients, and payers that they serve. Only by adding more value will labs be able to win an adequate share of the shrinking money available to pay for healthcare services.